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Outcomes of palatometry therapy as perceived by untrained listeners Williams, Rhea Joy

Abstract

The goal of this study was to determine the effectiveness of speech therapy using palatometry on activity limitation (World Health Organization [WHO], 1997) for speakers with speech impairments. Prior to this study, three adults and four children received a course of therapy using the palatometer. All of the speakers had previously plateaued in their improvement using traditional speech therapy techniques. Following approximately 20 sessions using the palatometer, narrow phonetic transcriptions showed notable gains in phonetic accuracy. Post-therapy palatograms showed approximations which were considered closer to normal than pre-therapy productions. The transcriptions and palatograms provide indices of impairment (WHO, 1997). Specifically, accuracy of phoneme production is measured. However, the question of whether or not the gains resulting from therapy reduce activity limitation remain unaddressed by such measures. The speakers' own perceptions of improvement were one indication that reduction in activity limitation was an outcome of therapy. To assess effects on activity limitations, sixteen untrained listeners (who were unfamiliar with disordered speech) were asked to perform two tasks. The first, a judgment task, involved choosing which of two sentences (one pre-therapy and one post-therapy) was "easier to understand." The second was an identification task with two parts. Listeners orthographically transcribed a set of ten words which contained in total seven to ten phonemes that had been targeted in therapy. They also transcribed three sentences. These tasks were performed by the listeners for each of the seven original speakers. Word transcription and goal phoneme identification within the word transcription by the untrained listeners improved significantly for five of seven of the speakers involved in therapy. An improvement between 11% and 30% in word identification and goal phoneme identification appeared to result in untrained listeners judging post-therapy samples as "easier to understand" in the judgment task. In general, the untrained listeners were least successful in noting improvement for adults with mild speech disorders. Speakers with mild impairments whose initial intelligibility was high (i.e., 90% or better) seem to require greater improvement than speakers with severe impairments, if gains are to be noticed by the untrained listener. The perception of untrained listeners in this study indicated that palatometry therapy provided an effective method of reducing limitations on the activity of producing intelligible speech for speakers with a variety of speech disorders.

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